Plastic Fantastic: UW Health's Pediatric Plastic Surgery Program
MADISON - Theresa Strine assumed that the birth of her third child would go as smoothly as her first two. She couldn't have known that her son, TJ, would be born with a condition called Pierre Robin Sequence - his lower jaw was both unusually small and set back, creating a dangerous blockage in his airway.
"My doctor told me he'd be having surgery at two days old," recalls Theresa, a CAD technician for an engineering firm in Spring Green, Wis. "To me, there was no way. I couldn't grasp it."
As it turned out, a heart defect meant that TJ would wait several weeks longer to have his surgery - a new procedure called mandibular distraction.
Using a device that allows no movement or shift, Dr. Delora Mount, a UW Health pediatric plastic surgeon, surgically inserted a pair of small pins into TJ's jaw. Over the course of the next week, Dr. Mount repeatedly turned the pins a micoscopic amount, gradually moving TJ's jaws apart and allowing the bone to grow and fill in the gap.
"In most cases, we want to bring the jaw out far enough that we overcome their airway obstruction," explains Dr. Mount.
TJ's surgery occurred in 2005. Two years later, his appearance and breathing are completely normal - an outcome that thrills the entire Strine family.
"Up until this happened to my son, I considered plastic surgery as an optional thing," says Theresa. "For TJ, it was a matter of life and death."
Treating a Range of Deformities
TJ is just one of hundreds of children each year whose lives - and appearances - have been improved by UW Health's multidisciplinary pediatric plastic surgery program. The program includes Dr. Michael Bentz, Dr. Mark Kiehn, Dr. Delora Mount and Dr. John Siebert. Together, they treat a wide variety of congenital and acquired deformities in children, from cleft lip and palate to fused fingers and micrognathia.
And while most of the procedures UW Health surgeons treat might be defined as cosmetic, to the patients, they're also functional, and, in many cases, essential for normal growth and development.
"A lot of people think it's called plastic surgery because we put plastic in the kids," says Dr. Mount. "But the fact is, nothing could be further from the truth. What we're doing is taking tissue from one area in the body and molding it to function in a different area."
Some procedures, like cleft lip repair, can be done early, when a child is between 6 weeks and 12 months old. Others, like cleft palate repair, generally occur later, when the child is old enough to handle a major surgery. Patients are monitored post-surgically for any speech or hearing problems, as well as any future orthodontic or jaw surgery needs. The surgeries, while complicated, generally only require a single night's stay in the hospital.
"The patient success rate on these types of surgeries is very high, both from a speech standpoint and a healing standpoint," says Dr. Mount.
Recontouring the Face
Once Drs. Mount, Kiehn and Bentz have done their work, Dr. Siebert steps in, using tissue from other parts of the body to recontour the child's face, sculpting what's missing to correct any remaining irregularities.
"It's a little like building a house," says Dr. Siebert. "To do it well, you need a team approach. We're trying to give the child's face a natural flow, to make it look pleasing and harmonious."
Not surprisingly, this type of procedure can be draining, both on the patients and their families. To ease the process, UW Health surgeons use pre-surgery counseling sessions (including before and after pictures) and testimony from parents whose children have successfully completed surgery to help new patient families navigate the process.
"When we show them the pictures, each family is amazed at what a difference it makes, both aesthetically and functionally, to their child."
With the opening of the new American Family Children's Hospital in August 2007, UW Health's pediatric plastic surgery program will expand to a larger space and a greater role. For more information about the program or to refer a patient, call (608) 263-2376.
Date Published: 03/14/2008